The factors that led Dr. Robert Masson to drop Medicare patients

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Robert Masson, MD, of Masson Spine Institute in Orlando, Fla., had to weigh a tough decision amid financial headwinds and declining CMS pay.

Dr. Masson discussed his choice to stop accepting Medicare patients with Becker's.

Note: This response was lightly edited for clarity.

Dr. Robert Masson: This summer we had a consulting firm do an analysis of profitability for our clinical practice. We were stunned to learn that for the last two years, relative to reimbursement for surgical evaluation and healthcare, we, as an independent practice, had paid six-figure losses for the privilege of taking care of this very special group of patients. 

I historically had provided this service happily and understood that the margins were slim.  Unfortunately, as the price deterioration has continued, costs and inflation skyrocketed, layers of clinical practice management more complicated, more staff members at a higher cost and the need to maintain physician extenders to cover the administrative and clinical burdens, we do not have a way to put Medicare patients in the black. Regrettably, I have made the choice to drop Medicare October 1, 2023.  

It is stunning to me that as CPI is sustainably increasing, cost of service and resources increasing, surgical fees have already been reduced, while the cost of liability protection and the risk greater than ever, that organized healthcare has not been able to move the needle. I am near the end of a 35-year career, but I hope that this gets sorted out before the next generation of healthcare has no other options. Obviously employed surgeons will only be affected if their employers start adjusting their salaries accordingly, which admittedly usually happens on the second contract.

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